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General NPI Number Information
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NPI Number | 1477254761
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Entity Type | Organization
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Legal Business Name | SHAAN& COMPANY, LLC
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Dates
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Enumeration Date | 03/14/2023
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 231 W BAY AVE
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City | LONGWOOD
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State | FL
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Zip | 32750-4125
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Country | US
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Telephone | 74-554-5804
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Fax |
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Provider Business Mailing Address
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Address Line | 1075 EDENS GATE CT
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City | LONGWOOD
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State | FL
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Zip | 32750-3980
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Country | US
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Telephone | 407-731-0252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CLINTON GIOIELLI
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Credential |
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Telephone | 407-760-6172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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